Surgical hand access apparatus

Abstract

A surgical access apparatus includes a liner base and an access housing for positioning outside the body. The liner base includes an inner member adapted for insertion through an opening within body tissue for positioning within the body; a sleeve member connected to the inner member and dimensioned to extend from the inner member through the opening within the body tissue, and a plurality of tensioning elements connected to the inner member and associated with the sleeve member to impart a tensioning effect on the sleeve member. The access housing includes a first element and a second element. The second element is operatively connected to the tensioning elements and adapted for rotational movement relative to the first member to cause the tensioning elements to displace the inner member toward the access housing and to cause the sleeve member to engage and retract tissue defining the opening within the body.

What is claimed is: 
     
       1. A surgical access apparatus comprising:
 a liner base including:
 a lower ring adapted for insertion through an opening within body tissue; 
 an upper ring adapted to be positioned outside the body tissue; and 
 a sleeve defining a passageway having a first diameter, the sleeve interconnecting the lower and upper rings, at least a portion of the liner base adapted for positioning within the opening in the body tissue to line the opening and retract the body tissue defining the opening, the liner base configured and dimensioned to displace the lower ring towards the upper ring; 
 
 an access housing operatively coupled with the liner base such that rotation of the access housing about the liner base causes retraction of the opening within the body tissue and transitions the passageway of the sleeve to a second diameter larger than the first diameter, while the sleeve remains rotationally stationary; and 
 a seal, at least partially supported by the access housing and providing access to the opening in the body tissue. 
 
     
     
       2. The surgical access apparatus according to  claim 1 , wherein the access housing includes an outer base including a U-shaped trough configured and dimensioned to releasably receive the upper ring of the liner base. 
     
     
       3. The surgical access apparatus according to  claim 2 , wherein the outer base forms a bottom portion of the access housing. 
     
     
       4. The surgical access apparatus according to  claim 3 , wherein the access housing includes a ratchet hub which at least partially supports the seal. 
     
     
       5. The surgical access apparatus according to  claim 3 , further comprising a duckbill valve mounted within the access housing. 
     
     
       6. The surgical access apparatus according to  claim 1 , wherein the seal comprises a gel material. 
     
     
       7. The surgical access apparatus according to  claim 6 , wherein the gel material has compressible characteristics to permit the seal to conform and form a seal about objects inserted therein. 
     
     
       8. The surgical access apparatus according to  claim 7 , wherein the gel material is a urethane gel. 
     
     
       9. The surgical access apparatus according to  claim 7 , wherein the gel material is a silicone gel. 
     
     
       10. The surgical access apparatus according to  claim 1 , wherein the access housing is configured to selectively lock a rotational position of the access housing relative to the liner base. 
     
     
       11. The surgical access apparatus according to  claim 1 , wherein the sleeve is rotationally stationary with respect to the lower ring. 
     
     
       12. A surgical access system, which comprises:
 an access member including:
 lower and upper segments; and 
 a sleeve dimensioned and adapted for positioning through a tissue tract to substantially line the tissue tract, the sleeve defining a passageway having a first diameter; 
 
 an access housing mounted to the access member, the access member and the access housing defining a passage therethrough; and 
 an access seal mounted to the access housing, the access seal dimensioned and adapted to establish a substantial seal about an arm or hand of a clinician; and 
 a trocar adapter releasably connectable to the access housing in the absence of the arm or hand of the clinician, wherein the access housing is operatively associated with the access member such that rotation of the access housing relative to the access member causes retraction of an opening in tissue and transitions the passageway of the sleeve to a second diameter larger than the first diameter, while the sleeve remains rotationally stationary. 
 
     
     
       13. The surgical access system according to  claim 12 , wherein the trocar adapter includes a trocar sleeve dimensioned for reception of a surgical instrument, the trocar sleeve at least partially disposed within the passage of the access member when the trocar adapter is mounted to the access housing. 
     
     
       14. The surgical access system according to  claim 13 , wherein the trocar adapter further includes a trocar housing having a trocar seal dimensioned and adapted to establish a substantial seal about the surgical instrument, the trocar sleeve extending from the trocar housing, the trocar adapter including an adapter base adapted to releasably mount to the access housing of the access member. 
     
     
       15. The surgical access system according to  claim 14 , wherein at least one of the trocar housing and trocar sleeve is connected to the adapter base.